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Randomised Study: Effects of the 5-HT4 Receptor Agonist Felcisetrag vs Placebo on Gut Transit in Patients with Gastroparesis

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Protocol approach 1: immune rebalancing (thymosin alpha-1 plus KPV) Goal: Restore regulatory immune function while reducing inflammatory signaling Components: Thymosin alpha-1: 1.6 mg subcutaneously twice per week (promotes Treg expansion, modulates dendritic cells) KPV: 200-500 mcg daily, orally or subcutaneously (inhibits NF-kB, reduces TNF-alpha and IL-6) Rationale: Thymosin alpha-1 works at the cellular level to rebuild the regulatory arm of the immune system, while KPV addresses the inflammatory signaling that drives acute symptoms